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Purpose: Despite a highly progressive legislation and clear governmental commitment, living conditions among persons with disabilities in Namibia are systematically lower than among persons without disabilities. This implies that persons with disabilities are denied equal opportunities to participate and contribute to society, and consequently are denied their human rights.

Methods: EquiFrame, an innovative policy analysis framework, was used to analyse Namibian Policy on Orthopaedic Technical Services. EquiFrame evaluates the degree of stated commitment of an existing health policy to 21 Core Concepts of human rights and to 12 Vulnerable Groups, guided by the ethos of universal, equitable and accessible health services.

Results: A number of Core Concepts of human rights and Vulnerable Groups were found to be absent in the Namibian Policy on Orthopaedic Technical Services, and its Overall Summary Ranking was assessed as Moderate.

Conclusion and Implications: The Namibian health sector faces significant challenges in addressing inequities with respect to its policy on Orthopaedic Technical Services. If policy content, or policy ‘on the books’, is not inclusive of vulnerable groups and observant of core concepts of human rights, then health practices are also unlikely to do so. This paper illustrates that EquiFrame can provide the strategic guidance for the reform of Namibian Orthopaedic Technical Services policy, leading to universal and equitable access to healthcare.

Shoulder pain among paraplegic persons has negative effects on their lives. The prevalence of shoulder pain among persons with spinal cord injury (SCI) varies from 30% to 70% in different studies and may be related to repetitive use of the shoulder during self-care and wheelchair-related activities.

Purpose: This study focused on the prevalence of shoulder pain and examined its effects on activities of daily living and social participation, and on functional, work and recreational or athletic activities. It also aimed to detect the degree ofsatisfaction with shoulder functioning in wheelchair users who were paraplegic due to spinal cord injury, in the Gaza strip.

Methods: Cross sectional study design was used to collect data from 80 persons with paraplegia, post rehabilitation, who were still using manual wheelchairs (MWC) for ambulation. After giving informed consent, the selected persons were interviewed directly in their homes, and filled questionnaires which included demographic data, Wheelchair User’s Shoulder Pain Index (WUSPI) and Shoulder Rating Questionnaire (SRQ).

Results: The prevalence rate of shoulder pain among paraplegics who use manual wheelchairs was 62%. Pushing a wheelchair for 10 minutes or more, and propulsion up ramps or inclines outdoors were the most common activities that caused and exacerbated shoulder pain. Sixty four percent from among the study sample mentioned that they had no limitation in shoulder-using ability during daily personal and household activities, while the rest experienced different degrees of limitation. Seventy-four percent reported no limitation during recreational or athletic activities, while the rest (26%) agreed that pain has variably limited their participation in these activities. Fourteen percent from the sample rated the overall degree of satisfaction with their shoulder functioning as fair, and the rest rated their satisfaction from good to excellent.

Conclusion: Shoulder pain, ranging from mild to severe, was highly prevalent among SCI paraplegics who use MWCs during their usual activities, and other activities which involve wheelchair propulsion. About two- thirds of the subjectsreported no limitation in shoulder use during daily personal and household activities and in recreational or athletic activities.

Purpose: This article aims to present the role of community health workers in the implementation of a comprehensive CBR Programme in rural Mongolia, and to explore the main challenges that arise in this specific geographical and socio-economic context.

Methods: Qualitative data were collected through semi-structured interviews with CBR workers from three selected provinces; short meetings and interviews with respective provincial level CBR coordinators complemented the information acquired. Additionally, a workshop with national level CBR stakeholders was carried out in order to review and discuss the findings.

Results: The study highlighted a number of practical barriers (including long distances and lack of transportation, low population density, and harsh climate conditions) which constrain the work of community health workers in the areas studied. In relation to disability, the study shed light on the difficulties found by community workers in shifting from a medical approach to disability to a new approach that emphasizes prevention and rehabilitation. Exploring interviewees’ experience in the five areas of CBR (health, education, livelihood, social, empowerment) the authors found that working in the areas other than health is perceived as difficult due to insufficient training as well as objective contextual barriers.

Conclusions: Despite many challenges, CBR represents a significant improvement for disability action in rural Mongolia. In this context, the local community health workers are well suited and willing to act as CBR workers; nonetheless, more training and some tailoring work to adapt the Programme to the context is needed if all potential results are to be achieved.

Limitations: This study did not include direct observation of CBR activities or consultation of beneficiaries and other stakeholders. Their involvement and consultation would certainly improve the understanding of all the issues raised.

Purpose: This study explores the perceptions, knowledge and attitudes of LHWs towards children with disabilities in Pakistan. It considers the feasibility of utilising the LHWs for prevention, early identification and management of disabilities for these children in the community.

Methods: Two Focus Group Discussions (FGDs) were conducted with 15 Lady Health Workers (LHWs), and two In Depth Interviews (IDIs) with LHWs of both a semi-urban and a rural community of Pakistan.

Results: LHWs were found to have major concerns and strong emotions regarding children with disabilities. They also revealed the insensitive attitude of community members towards these children. While they understood the major types and magnitude of disabilities better than lay persons, they lacked the knowledge to manage these disabilities. Consanguineous marriages were identified as the main cause of disabilities. LHWs reported that education and health facilities were lacking in semi-urban and rural areas, and demanded that the government provide these facilities for the children. They also expressed their willingness to work for these children, provided they had the approval of higher authorities and were given proper training.

Conclusions: This qualitative exploratory study recommends that the existing primary health system be reviewed, and the possibility of introducing community based rehabilitation services, utilising LHWs’ services for children with disabilities, be examined. In this regard, it is imperative to assess the existing training modules of LHWs and to introduce modules on prevention, early identification, and management of children with disabilities. It is also necessary to employ mass media to spread awareness about persons with disabilities.

Background: Cerebral palsy is a type of non-progressive central nervous system disorder with multiple impairments. As there are sensory, communicatory and intellectual impairments, providing care at home may be stressful and affect to the physical and mental health of the caregivers. This in turn could interfere with rehabilitation of persons with cerebral palsy.

Purpose: This study assesses the mental health status and quality of life of caregivers of persons with disabilities. The study group consisted of caregivers of 23 children with cerebral palsy and intellectual disability.

Method: The needs of the children with disabilities were assessed using a pre- tested interview schedule, while caregivers were administered GHQ-28 and WHO-QOL.

Results: Thirteen (56.52%) of the primary caregivers tested positive for GHQ. The psychological and environmental domains of QOL were found to be most affected, while the physical and social domains were relatively better.

Conclusion: There was a significant (p<0.05) correlation between the GHQ scores and quality of life.

This document explores the linkages between community based rehabilitation (CBR) and the convention on the rights of persons with disabilities (CRPD). It presents introductory information about the CRPD, CBR and the linkages. It then details CBR as a strategy for implementing the CRPD by highlighting experiences and principles